| NPI | 1447581947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070021705) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 1103882) |
| 225100000X Physical Therapist (Licence: GA PT009712) | |
| 225100000X Physical Therapist (Licence: MO 2008033383) | |
| 225100000X Physical Therapist (Licence: PA PT019536) | |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2016-03-07 |